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General NPI Number Information
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NPI Number | 1841471554
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Entity Type | Organization
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Legal Business Name | JOHNSON CHIROPRACTIC PC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 4600 KIETZKE LN SUITE N258
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City | RENO
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State | NV
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Zip | 89502-5033
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Country | US
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Telephone | 775-826-2200
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Fax | 775-826-2492
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Provider Business Mailing Address
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Address Line | 4600 KIETZKE LN SUITE N258
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City | RENO
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State | NV
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Zip | 89502-5033
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Country | US
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Telephone | 775-826-2200
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Fax | 775-826-2492
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT TED JOHNSON
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Credential | D.C.
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Telephone | 775-826-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DCB417
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License Number State | NV
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